Machine Learning, Big Data analytics, Artificial Intelligence have made the space of DigitalHealth even more interesting. Emerging markets like India are taking on these learning and bringing exciting business models. This blog is about Dr Dass's involvement in such projects and case studies. more on www.healthcursor.com

Thursday, 17 September, 2009

The goal of this Blog of mine is to gather an inter-disciplinary group to explore this hypothesis: that mobile-computing technology can enhance the health and well-being of Indians. For these Solutions and Services, I wish to define it under three sessions for e.g.

Tuesday, 15 September, 2009

Mobiles have revolutionarised Healthcare, a big way, They are further going to make a mark in developing countries like India because of its reasonable penetration, Good subscriber base and ease to use.

The availability of low-cost mobile phones and the already broad coverage of GSM networks in India is a huge opportunity to provide services that would trigger development and improve people’s lives.

Today's Newspaper (Times of India) says- "3G Handsets to cost less thanRs. 5000 In a year"..Read more on Page 17 tuesday, September 15, 2009.

Yesterday, When a friend asked me - How secure will be the consultations provided by doctors over mobiles??, Say if somebody changes or tampers the prescription before it reaches the target consumer?, If there is some error in despatch , some inaccuracy etc., So till the time HIPAA compliance or HL7 server capacity is leveraged, Mobiles based Healthcare delivery will continue be a falcy. The Good News , Dr Neelesh shared with me on Health on Mobiles that there will be HIPAA compliant Doctor Diagnosis/consultations available now. The mVisum Medical Communication System is a communication tool that allows medical professionals to securely receive, review and respond to patient data recorded at the point of care.Information is transmitted via secure HIPAA compliant internet servers then transmitted through mobile technology to the required physicians’handheld smartphone.Lets take an example , Have you heard of EKG, something like the picture below.We know this by ECG. A very common diagnostic procedure.

Using this service from mVisum, Of 600 EKGs read on a Blackberry mobile device, 599 were correct diagnoses.Great Accuracy. But is that 1% difficult to digest??

Lets move to privacy now, In order to take advantage of the technology, they use a GE Muse server and digital EKG. The mVisum software knows when an EKG is taken and grabs a copy (as does its internal EHR). If a call is placed regarding a patient, the cardiologist can scroll through the EKGs, locating the patient of interest and view the image off-site. Everything is server-based, so the EKG does not reside on the phone-when the physician logs out, there is no accessible data left on the phone. This is Great!

I was also impressed by 3Gdoctor.com's new concept. The Concept looks very interesting, But It costs a bomb, so not for rural market or to support connectivity in far flung areas. Folks in the UK have a new way to access medical assistance, i.e. via a 3G cell phone...it does not replace having a regular primary care MD, but it does cost...35 pounds per consultation...and accepts credit cards, pay pal, etc. It also offers the opportunity to create a personal health record here...no prescriptions given here. Once you have completed your Medical Questionnaire your answers will be sent for review by a registered Medical Doctor who is insured to practice by the Medical Defence Union or Medical Protection Society. Video conferences should be started within 1 hour of the request and are 24/7...365 days a year...and if you miss you call after 2- attempts, you will have a cancellation fee of 15 pounds. To Read more click here.

Successful examples like Aarogyasri and DrSMS in India suggest utilising mhealth for social causes, Health awareness and prevention.

Some better examples for developing nations like India come from Frogdesign and Frontline SMS.

They Say -“In the developing world, lack of infrastructure prevents health workers from delivering efficient healthcare to rural areas. As health workers travel from clinics to reach isolated patients, they are often as disconnected from central clinics as the patients they are trying to serve. The mission of FrontlineSMS:Medic is to advance healthcare networks in the developing world by building and distributing innovative, appropriate mobile technologies. The centerpiece of our system is FrontlineSMS, a free, open-source software platform that enables large-scale, two-way text messaging using only a laptop, a GSM modem, and cell phones. We are also developing several applications for the FrontlineSMS platform that will enable better patient management, electronic medical records via the cell phone, cheap mobile diagnostics, and mapping of health services.”

“Project Masiluleke (which means “lend a helping hand” in Zulu) is using mobile technology to tackle the worst HIV epidemic in the world in KwaZulu Natal, South Africa, where infection rates are over 40%. [frog design] is envisioning a solution that uses mobile technology in three crucial ways: 1) to encourage usage of low-cost diagnostic tools; 2) to walk patients through the testing process; and 3) to guide them into care should they need it, and encourage healthy preventative behaviors even if they don’t.”

Feedback and Suggestions Welcome!

1. How Should the Evolution of Mobile Healthcare Take Form? Simple or Advanced Services Development?

2. Where does mobile play a role - Limitations and Advantages, Extent of digitalisation, and support infrastructure required ?

3. Consumer Needs, Information Gaps and Role of the Ecosystem Player in the Healthcare Value Chain?

Friday, 4 September, 2009

ehealth 2009 was a very successful conference this year.The attendence was very impressive and it was great to see Public sector participation there.

In my session, i.e. Online and Mobile Applications in Healthcare –exploring new service channels and business models, Dr Rathan Kelkar, Director, Kerala IT Mission, Govt. of Kerala shared some of the robust Government initiatives as per Kerala's IT mission.Dr. SMS is one such Initiative.

The sole idea of the project is to help people to use their mobile phones to receive information on health resources and to provide the user with a comprehensive list of medical facilities available in that locality, such as hospitals having expertise in various medical specialties (Cardiology, Opthalmology, ENT etc).

To avail the facility the user has to send an SMS to a pre-designated number, the contents of the SMS should be the Pin code of the locality for which he or she wants to know about. This pilot was tried in Kozhikode District and after its success there, KSITM has rolled out the project in six more districts this year.

This session was one of the most interesting because of the Global participation.The stress was on Emerging markets and I was extremely happy to see participation from Dr. Shabbir S. Abdul, Researcher, National Yang Ming University, Taiwan; Dinusha Vatsalan, School of Computing, University of Colombo, Sri Lankawhere e-health and m-health models in Healthcare are now taking shape.

Mr. Nivedan Sahani, VP Government and PSU Enterprise Services, Airtel- shared what Operators are doing in the m-governance and mobile applications arena to strengthen e-health in India. He explained the initiatives in terms of rural healthcare in India through Aanganbari Projects.The Health MATE product which Mr. Sahani showcased was developed under the Use Case scenerio that a Field agent records symptoms of patient in rural area, sends to city based doctor for his online prescription, delivers medicine to patient.

India is one of the fastest growing Mobile markets in the world.In September 2008, Informa Telecoms & Media conducted the annual Mobile Content & Services Industry Survey. Of the 307 telecom industry professionals who participated in the survey, 71% believed that social networking & community services will have a significant impact on driving P2P uptake of mobile content. Healthcare services can therefore be benefited using social networking to doctor to doctor, doctor to patient and patient to patient social networking.

When I was speaking about the Immediate Business models on the platform ehealth and mhealth in India, I talked about challenges, Infrastructure, Budgets and Feasibility.I talked about simple Business Models like Health Tips, Health awareness messages, Pill reminders, LBS and support with Healthcare facilities and personalised Healthcare.

SIMpill is a successful example of SMS, being used to help combat diseases.It is about making sure people take their medication. It was used during a 2007 trial in South Africa to ensure people took their medication for TB. In the pilot, 90% of patients complied with their TB medication compared to 22% to 60% take-up without it.

I talked about basic issues of Encouragement, Awareness and Assurance which are very critical and important in healthcare.India (as per Economic Times) will get back to 9% growth by September 2010- reiterating the Centre’s commitment to create more spending power in the hands of people especially growth of rural India. This will call for convenience and better health standards. Success will hence be particularly in the area of health awareness schemes and training health care professionals.

Mobile phones are generally affordable and available to the population at large, making them more accessible than computers and far more cost-effective than hospital beds.Therefore Mobiles in developing countries can boom the existing Telehealth and ehealth industry, by providing more reach, better impact and more involvement and awareness about such initiatives.

The Brainstorming went interesting when all revenue models started talking about the direct relationship between improved communication and access to health care, also Increasing numbers of subscribers and coverage reaching & superceding MDGs for connectivity.Where I was addressing Clear plans for sustainability,Mr. Nivedan Sahani rightly stressed on Training and capacity development.

Mr. KVRK Rao, VP Marketing, SG technologies, came across as a Knowledgeable Speaker talking about full network participation for Successful integration. He successfully cruised us through Creative combination of new and old technology in his new range of products.

The Session concluded on a clear picture regarding Value add for the consumer in terms of Enhanced quality of care, Enhanced disease surveillance and control as well as Increased productivity within health system and profitability for the provider so as to reduce feelings of isolation for health care workers as well as consumers as a part of the overall Healthcare services network in India.